New Client Intake Form
Please answer all questions and attach pictures. If form is not fully filled out or pictures are not included it will be denied and a new form will need to be filled out. Once I have reviewed your form I will reach out within a few days via email so please check junk mail if you haven’t received a response from me.
Client's Name
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First Name
Last Name
Client's Phone Number
*
Format: (000) 000-0000.
Client's Email Address
*
example@example.com
Upload an image of an inspiration hair style or hair colour.
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Upload an image of your current hair. Please make sure this is a current photo of your hair, taken with ample lighting and hair is not in a ponytail. Views from front and back are preferred
*
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When did you last visit a hair salon?
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Month
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Day
Year
Date
What service did you have done at that appointment
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What appointment times work best for you?
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Weekday am
Weekday pm
Saturday
What services are you interested in booking? Please refer to my service menu in the highlights on my Instagram page if you are unsure.(all services are individual, please specify if you need a cut or blowdry with your colour service)
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Full Highlight(traditional highlight to root)
Partial Highlight(traditional highlight to the root ear forward )
Face Frame Highlight(brighten up the hairline)
Modern Blonde (low maintenance blonde utilizing various balayage and blonding techniques. Glosses are included in this service)
Modern Bronde (low maintenance lightening on brunette hair to achieve subtle pops of light throughout the hair using balayage and highlifhting techniques. Glosses included)
Root Touch up(grey coverage, no bleach)
Reverse Balayage (adding dimension and lower maintenance to your existing blonde)
Partial Lowlight(grey blending)
Full Gloss(brunette full refresh)
Full Brunette Transformation(going full dark from blonde)
Toner(gloss after highlight service or to maintain highlighted tone)
Root Tap(softens highlight lines at root for a lower maintenance grow out)
Haircut
blowdry
Extension consult
If you chose weekday PM please specify after what time will work for you.
Are we making a change or maintaining current style/colour?
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Making a change
Maintaining
Would you consider your hair…(this refers to the amount of hair not the individual strand)
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Thin(amount of hair/density is low)
Average(amount of hair/density is medium)
Thick(amount of hair/density is high)
Super Thick(amount of hair/density is very high)
If you are booking a highlight or lightening service please specify if there is permanent colour on your hair now or in the past that we would be lifting out. (this does not include bleach)
Yes
No
If you Answered yes to the previous question, how long ago was permanent colour applied to your hair?
Do you have grey hair that we will need to cover or blend?
Yes
No
What is the current condition of your hair?
Hair loss
Damage due to heat
Split ends
Breakage
Itchy scalp
Hair is dry
Dandruff
Other
Do you currently have extensions installed?
Yes
No
Have you used the following in your hair before? If there are any of these treatments or products in the hair a detox treatment on the day of your appointment will be required to make sure there are no chemical reactions and to prevent hair damage.
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Drugstore(box) hair color
Keratin Treatment
Relaxer
Henna
Natural shampoo
Hard Water/mineral build up
None
If you checked one of the boxes above please specify when these products were last used in your hair.
Please use this space to tell me any hair history you think is relevant to your future appointment or any other concerns.
Please let me know if someone recommended you to me so I can thank them!
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